No wonder so many care workers don’t seem to care
We know the pitiful care many elderly get during home visits. But one writer went undercover as a care worker to reveal the OTHER side of the story: exhausted staff treated little better than slaves
FROM the window of my cheap hotel I could see, peering out over the rows of terraced houses, the rusty red tip of the famous Blackpool Tower.
Illuminated at night, it dominates the town like a huge glowing torch driven up through the concrete.
But the bright and brassy seafront was the antithesis to this part of town, with its flea-ridden hotels, drunks, cannabis dealers, boarded-up shops and — after dark — prostitutes who loitered next to the cash machines touting for trade.
This was Central Drive, the most deprived area of Blackpool and one of the most disadvantaged places in England.
It was also the base for my mission to find out what it was like to be a worker in Britain’s minimum-wage economy — by becoming one myself.
I’d set out from London several months earlier to look for work in the sort of towns that rarely interest politicians unless there is an election in the offing — the sort of places where people’s jobs are increasingly less a source of pride and self-respect, just a lowly paid, insecure and exhausting daily assault on their dignity.
I was in Blackpool because I’d landed an interview for a job as a home care worker ‘ The elderly have been packaged up and sold to the lowest bidder ’ with a company called Carewatch UK, founded in 1993. It has 150 offices all over Britain, employs 3,500 carers and is ‘supposed to be one of the best’, as one of my co-workers put it to me.
My experiences would lead me to a very different conclusion.
Getting a job as a home care worker was extraordinarily easy. I simply phoned the number in the job advert, answered a few rudimentary questions: Do you have a car? (Yes) Do you live in the area? (I’ve just moved here) Do you have any experience of working in care? (No, but I looked after a friend of my grandmother’s for a while when he had dementia) and was summoned for interview. I had to present a few documents — some ID, the details of a willing referee — and agree to a criminal record check.
At the end of the interview I was offered a job — on a then minimum wage of £7.25-an-hour — and given a date for my induction.
The only tricky moment occurred when I casually mentioned that I wanted the job because I had ‘read good things about the company’ online. I was simply trying to make small talk and show I’d done my homework on my future employer.
But my comments turned out to be a huge mistake. My interviewer sprang to her feet, arms akimbo, shook her head fiercely and said that I ‘didn’t ought to pay attention to everything’ I read online.
A glance at the indeed.co.uk website later made it clear why I’d upset her so much. As well as hosting job advertisements,
indeed.co.uk allows users to post reviews — giving each company a rating of up to five stars — and write a brief comment.
After 477 employee reviews, the well-respected John Lewis department store chain had, at the time of writing, an overall rating of 4.2 stars out of five. Even fast-food restaurant McDonald’s, which is regularly derided by workers’ rights activists, achieved a respectable 3.6 stars based on 60,000 reviews.
Carewatch, on the other hand, scored a lowly 2.6 stars based on 157 responses.
Reading through some reviews was like perusing the testimonies of 19th century factory hands.
‘Office staff absolutely vile, and only slightly civil when they need extra [work] covering’. ‘ Rubbish company to work for. I was there six weeks before I got a weekend off. Even then they rang.’ ‘All the management are nothing but liars and overrun you with calls then drop you so your [sic] not earning.’ ‘You didn’t get paid for the time you were travelling between service users’ homes.’ And so it went on. All of this might have been highly unfair. But what came across was that the care sector was desperate for staff.
Today, our ageing population coexists alongside a stressed- out working population. The pressure to make ends meet by toiling away for longer and longer hours makes it increasingly difficult to take the time out to look after beloved parents and grandparents, who are living for longer.
Which is why Britain’s elderly often resemble, as one care worker would describe it to me, ‘units parcelled up and sold to the lowest bidder’.
My four-day induction began the Monday after my interview.
Aside from being shown how to use a hoist to lift and move an elderly person around, this was a tedious affair largely involving classroom instruction and form filling. There were eight of us — two men and six women. We were quickly taught how to empty and change a catheter, how to administer medication and what to do if we turned up at someone’s house and discovered them lying on the floor (dial 999 and do not pick them up!) By Friday, two of the women had quit. During the induction period we were given contracts to sign. In bold grey lettering on the front of these were the dreaded words: ‘Zero hours’.
Our contracts set out in stark terms exactly what this meant. ‘There may be times when no work is available for you and Carewatch has no duty to provide you with any work at such times, or any payment in respect of such times’, it read.
The company could send us out on a job at any given moment, but a brief phone call could just as easily inform us that there was nothing available for that week.
This, increasingly, is what work at the lower end of the pay scale in Britain entails. The insecurity was accepted by my co-workers as just another part of everyday life, like the daily commute.
‘That’s just how it is,’ staff said to me fatalistically.
In a similar vein, the contract also informed us that the work
‘ It sometimes felt to me like the company owned us ’
was conditional upon our agreement to work flexible hours.
If any of us had got another job as well — because, say, we needed more money — we would have to inform the company and Carewatch would ‘not have to provide you with any work if we reasonably feel . . . that it may conflict with work you should be doing for Carewatch’.
It sometimes felt as though the company owned us.
Of course, care workers form a vital role in any civilised country.
They turn up daily at the homes of the elderly, feeding them, bathing them, giving them medication and doing jobs that nobody else is available, or willing, to do.
They might even have been the last human being a person spoke to before slipping off this mortal coil. Yet as a society we treat carers very badly — or as ‘glorified cleaners’, as one care worker put it to me.
Several weeks after my induction, I was given the chance to do some home visits. I was still waiting for my criminal record check, but I could work alongside someone else with one.
A typical visit was scheduled for 30 minutes. That included all travelling time to and from the customer, which generally took around ten minutes. This left 20 minutes per visit. But some lasted for as little as five.
Appointments typically cost £10an-hour if the customer’s income exceeds the average £ 23,250 threshhold, under which local authorities pick up the tab. They were packed into each carer’s schedule like sardines in a tin.
If one overran — say, a customer was feeling unwell — it would invariably spill into your next, resulting in you spending the rest of the day racing around cutting visits short in a desperate attempt to make up the time.
If you were unable to play catchup, you could end up working entire days non-stop — from seven or eight o’clock in the morning until 10 or 11 at night — without so much as a tea or coffee break. In my experience, it was not uncommon to get to bed between midnight and one in the morning, before getting up again at six. On an average day, I would meet another carer between six and eight o’clock and work through until around 2pm.
I would then go on a break until around four or five o’clock in the afternoon until about 10pm.
I was lucky if I got any breaks — the job relied on the shift running like clockwork, which was far from likely when it involved looking after old and, in many cases, extremely poorly individuals.
Hazel, a 52-year-old Edinburghbased carer who does not work for Carewatch UK, told me: ‘If you overrun at any point that’s your two-hour break gone, because you’re back on duty at four and working till 10.30 at night. In reality, 10.30 is 11 — plus you’ve got your journey home.’ Rochelle, 40, a care worker from Newcastle, also did not work for Carewatch UK but another of Britain’s largest care providers. She had put in 12- day fortnights, working every day from 7.30am until 10pm.
‘I regularly worked 60 hours a week,’ she told me. ‘And I worked nine weeks when I first started without a day off. If you kick up a stink they cut your hours down.’
Rochelle knew one girl who got £62 for a 24-hour shift. This was because sleep-in carers are paid at an overnight rate which excludes hours slept, so often comes in below the minimum wage for total hours on the job. It’s not surprising, then, that care working is expected to face a staffing shortfall of a million people in 20 years. As well as the physical side, care visits were often emotionally draining. It would take a heart of stone not to be moved by some of the situations I encountered.
I saw instances of very elderly customers being left on their own by relatives with no food, necessitating in an unscheduled trip to the shops on our part to pick up essentials such as milk or bread.
Due to the sheer speed at which everything had to be done, not all carers would be able to carry out ‘extras’ like this. On one occasion I gave a blind man a bath, which took more than 20 minutes — the entire length of the visit.
There were other times when it was a case of staying with the customer longer than the allotted 20 minutes, or leave them at risk of neglect. Almost every carer had at least one story of an elderly person being left unfed or uncovered in a cold house. Time was constantly against us.
Carers I worked with would sometimes asked loaded questions to speed visits along — ‘You don’t need any shopping today, do you, Ethel?’ or, ‘You’re not hungry, are you, Brian?’ Not wishing to cause any trouble, the customer would invariably say ‘no’.
All of which works against any bond you might form with the person you are caring for.
Often, that was all people wanted once we’d taken them to the toilet or made them a cup of tea: a bit of company.
I would see the disappointment etched on their faces as we dashed out of their front door: the realisation that even a brief chat was too much to ask. We were racing against the clock and it was the customer who lost out.
The haste that dominated every aspect of the job could carry graver risks. I saw several instances of Medication Administration Record sheets being left blank when medicine had been given to the customer. This could easily have resulted in a poisoning if another carer turned up later that day, noticed that the column on the sheet was empty, and given the customer a second dose.
Home carer Hazel told me she’d once been sent to look after someone who ‘ had been given the wrong drugs on so many occasions that it’s surprising she wasn’t poisoned’.
She attributed this partly to the poor English-language skills of some care workers. ‘A lot of the carers’ English wasn’t good enough to read what she should be having, and when,’ she told me.
A growing number from Eastern Europe work in the care sector. Like their British colleagues, the majority are compassionate and hard-working.
Yet I got a sense from speaking to British carers that the companies knew they could demand a greater level of compliance from Eastern European workers than home-grown equivalents.
The threat of being replaced by an acquiescent migrant who is hard up and willing to put up with almost everything thrown at them was, according to care workers from other companies I spoke to, a permanent fear factor — sometimes darkly referenced in a nudge-nudge-wink-wink manner by the companies. ‘The attitude [is]... well, if you don’t like it, bog off, because we’ll get other people from other countries who will happily do it,’ said Hazel. She added: ‘Some migrant workers can’t even read the instructions on food to cook it correctly. They should have to take some kind of degree or an English exam at least that shows they can read and write.’
Indeed, a 2012 study of care homes in England found that 90 per cent of residents had been exposed to at least one medication error. But, according to Hazel, staff who alert management to medicine errors are not guaranteed to be listened to.
And with zero-hours contracts you don’t need to sack people; you just don’t give them any work.
As a result, the cared-for face a never-ending carousel of different people looking after them so there is no consistency in their care.
‘It’s so sad, because these [customers] are lovely people,’ Hazel said. ‘[They] quite often gave so much of themselves through conflicts such as World War II and Korea, and are intelligent, valuable human beings who get treated like dirt.’
AdApted from Hired: Six Months Undercover In Low-Wage Britain by James Bloodworth, published by Atlantic Books at £12.99. © James Bloodworth 2018. to order a copy for £10.39 (offer valid to 15/3/18), visit mailshop. co.uk/books or call 0844 571 0640. p&p free on orders over £15.
One woman was paid £62 for working a 24-hour shift ‘ I’d seen the pain etched on their faces as we dashed away’